The epithelial Na ؉ channel (ENaC) functions as a pathway for epithelial Na ؉ transport, contributing to Na ؉ homeostasis and blood pressure control. Vasopressin increases ENaC expression at the cell surface through a pathway that includes cAMP and cAMP-dependent protein kinase (PKA), but the mechanisms that link PKA to ENaC are unknown. Here we found that cAMP regulates Na ؉ transport in part by inhibiting the function of Nedd4-2, an E3 ubiquitin-protein ligase that targets ENaC for degradation. Consistent with this model, we found that cAMP inhibited Nedd4-2 by decreasing its binding to ENaC. Moreover, decreased Nedd4-2 expression (RNA interference) or overexpression of a dominant negative Nedd4-2 construct disrupted ENaC regulation by cAMP. Nedd4-2 was a substrate for phosphorylation by PKA in vitro and in cells; three Nedd4-2 residues were phosphorylated by PKA and were required for cAMP to inhibit Nedd4-2 (relative functional importance Ser-327 > Ser-221 > Thr-246). Previous work found that these residues are also phosphorylated by serum and glucocorticoid-inducible kinase (SGK), a downstream mediator by which aldosterone regulates epithelial Na ؉ transport. Consistent with a functional interaction between these pathways, overexpression of SGK blunted ENaC stimulation by cAMP, whereas inhibition of SGK increased stimulation. Conversely, cAMP agonists decreased ENaC stimulation by SGK. The data suggest that cAMP regulates ENaC in part by phosphorylation and inhibition of Nedd4-2. Moreover, Nedd4-2 is a central convergence point for kinase regulation of Na ؉ transport.The transport of Na ϩ across epithelia in the distal nephron, colon, and airway is critical to maintain Na ϩ homeostasis and to control the composition of airway surface liquid. Defects in Na ϩ transport are responsible for genetic and acquired forms of hypertension and hypotension (1) and contribute to the pathogenesis of cystic fibrosis (2-4). Na ϩ transport is mediated by the epithelial Na ϩ channel (ENaC), 1 which forms a pathway for Na ϩ to cross the apical membrane (5, 6). At the basolateral membrane Na ϩ exits the cell via the Na ϩ -K ϩ -ATPase, resulting in transepithelial Na ϩ absorption. Nedd4-2, an E3 ubiquitin-protein ligase, is critical in the control of Na ϩ transport. Nedd4-2 inhibits Na ϩ transport by catalyzing ENaC ubiquitination and degradation, resulting in reduced ENaC expression at the cell surface (for review, see Refs. 7-9). This requires binding of multiple Nedd4-2 WW domains to PY motifs (PPPXYXXL) located in the C termini of each ENaC subunit (␣, , and ␥). Disruption of this interaction by mutations that delete or alter the PY motifs increases ENaC surface expression and causes Liddle's syndrome, an inherited form of hypertension (10 -14).Recent work suggests that Nedd4-2 is negatively regulated by serum and glucocorticoid-inducible kinase (SGK), a Ser/Thr kinase. SGK binds to Nedd4-2 and phosphorylates it at three sites (see Fig. 3C), which reduces Nedd4-2 binding to ENaC (15, 16). Similar to Liddle's syndrome, decre...